CPT® Code 0217T

Add-On Code

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; second level (List separately in addition to code for primary procedure)

Paravertebral facet joints, also known as zygapophyseal joints, are critical structures located on the posterior aspect of the spine, situated on either side of the vertebrae where one vertebra overlaps another. These joints play a significant role in spinal movement and stability. Pain originating from these joints can be attributed to various conditions, including post-laminectomy syndrome, which may occur after spinal surgery that destabilizes the spinal joints, leading to scar tissue formation or recurrent disc herniation. Other potential causes of facet joint pain include degenerative conditions such as spondylosis, spondylolisthesis, and arthritis. The procedure described by CPT® Code 0217T involves the injection of a diagnostic or therapeutic agent into the paravertebral facet joint or the nerves that innervate that joint, utilizing ultrasound guidance for precision. This technique begins with the preparation of the skin over the facet joint, followed by the administration of a local anesthetic to minimize discomfort. A spinal needle is then carefully directed into the facet joint space until it contacts bone or cartilage, ensuring accurate placement. To confirm the correct positioning of the needle, a small amount of contrast material is injected. Subsequently, a local anesthetic and/or steroid is administered. The diagnostic facet joint injection aims to identify the specific source of pain by using a local anesthetic, while a therapeutic injection may be performed later if the patient experiences significant pain relief, utilizing a long-acting local anesthetic combined with a steroid. For coding purposes, CPT® Code 0216T is used for a single lumbar or sacral facet joint injection, CPT® Code 0217T is designated for the second level, and CPT® Code 0218T is applicable for the third and any additional lumbar or sacral levels injected.